PDep-20: The Scariest Emerging Side-Effect of Covid-19 is Not What You Might Think

Covid-19 has brought us a deadly Co-Pandemic that threatens the young – and the cure and prevention are a whole lot easier than for the virus itself.

Pic by Erik Mclean via Unsplash

© Je’anna Clements 2020 This article may be publicly shared in any medium for non-commercial purposes with attribution and without abridgement including this statement, without compensation.

“My son died from the coronavirus as I mentioned,” says father Brad Hunstable in a recent viral online video. “But not in the way you think.” 

There are two interlinked pandemics going on right now, and I’m not talking about the impact on the economy, domestic violence or starvation. 

Both pandemics are killers. Both will have lasting effects on a global scale. Both can be managed with strategies that will reduce overall harm – or with strategies that will maximise damage. The strategies used to manage them impact a lot more than the pandemics themselves. Our economic and political systems will be deeply affected by both. And it’s even possible that the long term effect of the second pandemic could be the worse of the two.

The first is known as Covid-19

  • It affects mostly the elderly. 
  • It’s really just like the flu that we’re all used to, that always kills a number of people every year – except it’s at least ten times worse. 
  • Worst-case scenario, death. 
  • For those who survive, there can be lasting damage to lungs, heart, kidneys, gut, and even mental health. For some there will be no return to ‘normal’, ever. 
  • It doesn’t affect everyone equally. 
  • Some will emerge from ICU completely recovered. 
  • Some who get solidly sick will not need hospitalisation. 
  • Many infected people will have no symptoms at all.
  • Vulnerable people include those with underlying physical conditions such as diabetes, obesity, and other ailments.

And the second pandemic? Is it the deadly Kawasaki disease lookalike PIMS-TS, that has been reported to affect some children who test positive for Covid-19? No. While PIMS-TS is horrific and tragic, it affects a very, very small number of children in the worst Covid-19 hotspots – plus it’s actively part of the Covid-19 pandemic itself.

The second pandemic has yet to be named, since it’s only starting to be noticed right now as I write.

Since it has a delayed onset that hits young people only as Covid-19 really settles in for the long haul in any location, let’s call it PDep-20.

  • It affects mostly the young
  • It’s also just like something we are already used to, that already harms and even kills a number of young people every year – except now it’s many times worse than usual as a result of social distancing measures. 
  • It doesn’t affect all young people equally.
  • Many affected young people will have no visible symptoms at all.
  • Some could suffer obvious acute effects such as anxiety and depression.
  • Some could need months or years to recover.
  • Some could have permanent damage that is life-long and persists through adulthood.
  • The milder of these permanent effects can include permanent learning difficulties, as well as a “lack of vital life engagement; diminished optimism; stuck-in-a-rut feeling about life with little curiosity or exploratory imagination to alter their situation; predilection to escapist temporary fixes…alcohol, excessive exercise, (or other compulsions); a personal sense of being life’s victim rather than life’s conqueror.” – Stuart Brown http://www.scholarpedia.org/article/Consequences_of_Play_Deprivation#Conclusions
  • More severe permanent effects could include a lack of ability to cooperate with others (Brian Sutton-Smith) impacted brain growth (Margaret Sheridan, PhD, and Charles Nelson, PhD) and homicidal tendencies (Stuart Brown).
  • Worst case scenario is death by suicide. 
  • Most at risk could be imagined to include only-children (with no siblings), children under 10 years of age, children in small homes with no yards, as well as highly social children and highly sensitive children – but it’s hard to be sure yet, exactly who will be worst affected.

Hunstable’s son had few or none of these risk factors. He was days away from his 13th birthday, a resilient, successful and popular boy who lived in a well-resourced middle-class loving home with a garden and a sister. The final straw for him seems to have been a temporary but sudden interruption of his ability to play with his friends online – the only place he had left to connect with them, the only place he could get at least a fraction of his social free play needs met .

‘PDep’ is short for Play Deprivation, and it’s a lot more serious than we might think, even under normal circumstances. The PDep-20 that is now setting in globally as a result of Covid-19 social distancing needs, is on a scale we have never faced before. 


What is Play Deprivation?

“Children need play as much as they need fresh air, clean water, and nutritious food.”

– Dr Peter Gray 

Play specialist Dr. Stuart Brown has found that “moderate-to-severe play deprivation during the first 10 years of life appears to be linked to poor early child development, later leading to depression, difficulty adapting to change, poorer self-control, and a greater tendency to addiction as well as fragile and shallower interpersonal relationships. Play deprivation in childhood has come up in numerous interviews that I have conducted with some of America’s most violent criminals.” https://www.childandfamilyblog.com/early-childhood-development/play-deprivation-early-child-development/

Brown further cautions us that “severely play-deprived children will tend to engage in automatic and repetitive activities, failing to engage socially. In later childhood, the play-deprived child may have more explosive reactions to circumstances rather than a sense of belonging. As adults, they are often unoptimistic and subject to smoldering depression due to a lack of joy in their lives. They tend to be more ideologically fixed and certain with little ambiguity in their social worlds. That’s because play fosters the social and emotional learning and acceptance that ambiguity is a part of complex and human interactions. https://goodmenproject.com/featured-content/deprivation-sjbn/?fbclid=IwAR2DfHmnoLzKuVZGvdueNw7GRZYtJoeFRRcRjcof–NDlKgM2fo5NGkD_oE

Play specialist Bob Hughes agrees that “Chronic play deprivation may have the effect of gradually dehumanizing the children it affects, with a consequent loss of their ability to care, to empathize and exercise compassion, or share the same reality as other children. The available evidence suggests that play deprived children become disturbed, aggressive and violent adults” – Insights and understandings: Developments in playwork theory 2003

How long is ‘chronic’? If we sustain play deprivation for months on end, and maybe even sabotage free play for a year or more, what will that cost this young generation? How will that impact the world when a cohort of play deprived adults eventually enters the work-place? How much will it shift our sense of ‘normal’ for play, and shape social habits and practices that ensure play deprivation for the generations to come? 

The problem is that there is no way to know, except for hindsight – and that’s not a good way to find out.

What kind of play are we talking about here?

Play deprivation refers to what happens when young people lack sufficient opportunity to play 

* in a free, unstructured and spontaneous way 

* with peers, 

* at a level of physical proximity that feels relaxed and sociable.

Frost and Jacobs, Play Deprivation: A Factor in Juvenile Violence, 1995 

Outdoors in nature is the ideal place, full uninterrupted days are the best, and the more exploration and adventure that is possible, the better. This is the rich, nourishing play associated with holidays at the beach or in the mountains, and long summer breaks. Instinctively, we know that this is what makes for optimal childhood. After all, it’s in our genes – this is the way that young people have developed for hundreds of thousands of years.

However, like a starving man licking spilled soup off the floor, young people will take whatever scraps they can get – in the car and the bus, in classrooms at their desks and while walking from class to class, in the supermarket aisle and anywhere else where they find themselves together with peers. Even without ideal conditions, in ordinary life, many young people manage to scrounge just enough social free play to ward off the worst damage. 

Covid-19 doesn’t allow for ordinary life.

Play-based learning, play with adults, externally structured play or play under conditions that are too restrictive, adult-driven play, play alone without peers, play with peers through virtual means – none of these are sufficient to combat play deprivation. Board games and organised sports don’t cut it. It also isn’t about ‘entertainment’. Keeping kids ‘busy’ and ‘having fun’ can distract them from the fact of their deprivation, but this does not mean that their social free play needs have been met, any more than feeding them candyfloss will take care of nutrition.

Only free, unstructured social play with peers who are physically present, meets this particular need.

Why Has This Essential Need Been Neglected Until Now?

It is understandable that adults have failed to realise this looming impact on young people. Sadly, there is not a very wide understanding of the role of this kind of play. Why would there be? It usually just happens. 

We are not used to paying attention to how important this kind of play is, simply because we can usually afford to take it for granted. It just happens in the spaces between the things we think matter more, whenever young people have time with each other. It’s sort of invisible, except when it becomes rambunctious enough that we are moved to intervene. Adults have relatively little to do with providing it, so we generally don’t notice its significance. It is easy to make the assumption that it is trivial, and therefore optional. 

At a time like this, that assumption becomes very dangerous indeed.

However, at a time like this adults have so much to deal with and so many other challenges to face, that is exactly the assumption that has automatically been made. It’s urgent to reconsider.. 

How did play deprivation show up before Covid-19?

As access to open space has declined, media-fuelled paranoia about safety from stranger-danger has boomed, levels of homework have grown, recess times have shrunk, and structured extra-murals have become more common, researchers have already been spotting the serious and growing effects of play deprivation for several decades. 

Now, with Covid-19, things have become suddenly, enormously worse.

Writing about the ‘ordinary’ societal levels of play deprivation that we sadly might have come to consider to be as normal as the flu, psychologist Lisa M Lauer points out that “Negative effects resulting from play deprivation include an increase in violent crimes, decreases in brain and muscle fiber development, and reduction in communication, problem-solving, and social skills. Further evidence of play deprivation exists indicating children are at greater risk for aggressive behaviors and an increased risk of obesity.” Play Deprivation: Is It Happening In Your School Setting?  https://files.eric.ed.gov/fulltext/ED524739.pdf 

Mental Health, Development, and Resilience

Obviously play deprivation is not the only source of stress for young people at this time, and not the only factor that will contribute to healthy development and well-being as well as suicide prevention. However, free social play is a tonic that strengthens and nourishes children’s resilience in the face of other challenges.

On the one hand Peter Gray points out that “children are, on average, happier in social play with friends than they are in any other situation” and so it is no surprise  that “play, especially social play with other children, serves a variety of developmental functions, all of which promote children’s mental health.” 

On the other hand, says Gray, “In the absence of such play, children fail to acquire the social and emotional skills that are essential for healthy psychological development.” https://www.psychologytoday.com/files/attachments/1195/ajp-decline-play-published.pdf

Free play with peers is known to help young people work through their problems, relax, and decompress. It actively builds their resilience and coping skills. It also addresses all three of the essential human needs of Autonomy, Competence and Relatedness identified by Richard Ryan and Edward Deci as being core to human well-being. In addition “through such play, children grow and learn, even though these adaptive outcomes are not their conscious goal”. The Oxford Handbook of Human Motivation, Edited by Richard Ryan 2019.

In addition, “Children permitted to play freely with peers develop skills for seeing things through another person’s point of view—cooperating, helping, sharing, and solving problems” says Lisa M Lauer. Surely these are all skills that young humans will need more than ever, during crises like these and the years ahead?

How Real Is The Danger?

How long can young people go without this type of play, before damage sets in? How long is too long? We don’t know – and that ignorance is dangerous. 

Hunstable’s son is already far from being the only young Covid-19 suicide – South Africa’s ten-year-old Rethabile Mohale comes to mind. This suggests that damage could already be significant for many young people. Let’s bear in mind that for every suicide, we have no idea how many other young people are staying alive and ‘coping’ but being acutely or permanently harmed.

“Rather than ‘bouncing back’ as many adults seem to expect, children incorporate trauma into their growth and future lives. Unfortunately, adults do not usually consider this in their policy making, especially when it comes to dealing with a crisis,” says Kholofelo Mphahlele

“The mental health toll of the coronavirus pandemic is only beginning to show itself, and it is too early to predict the scale of the impact,” says Bennedict Carey” https://www.nytimes.com/2020/05/19/health/pandemic-coronavirus-suicide-health.html

“Secondary consequences of social distancing may increase the risk of suicide,” say psychiatrists Reger, Stanley and Joiner, adding that “Suicidal thoughts and behaviors are associated with social isolation and loneliness.” https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764584

Aside from the personal danger to individual young people, we also need to consider the potential long term impacts on society. Play deprivation is associated with increased antisocial and violent behaviour and narcissism. Frost and Jacobs noted that “the increasing number of violent crimes committed by children is a result of play deprivation.”  

With the relatively moderate levels of play deprivation increasingly affecting young people in mainstream schools even under normal circumstances, what can we expect from a massive, global level of play deprivation during a time of increased stress when young people need play more than ever, in order to help them cope?

Education

Many adults who have noticed the recent decline in many young people’s wellbeing have urged for the reopening of schools in the hopes that this will help. However, aside from the fact that large schools offer a far worse scenario for mass Covid-19 infection than the smaller groups involved in free play, many schools under Covid-19 circumstances don’t plan on meeting these particular needs at all. The need for free play cannot be met by any kind of classroom activity, nor even by a carefully spaced social-distancing playground.

“Skills are temporary; meta-skills are permanent.” Gustavo Razzetti https://liberationist.org/the-metaskills-you-need-to-thrive-in-the-21st-century/

And ironically, while schooled activities cannot help with the need for free play, free play is crucial to building the foundations for successful learning such as the increasingly important “4 C’s” of creativity, communication, critical thinking and collaboration. Meta skills such as problem solving, reasoning, planning, self-direction, resilience and persistence are all developed through free play.

Ironically, Self-Directed Education case studies suggest that the content learning that happens in classrooms can be caught up later – as long as meta-skills are intact. Meta skills that don’t get developed, however, can make it hard to learn content effectively. South Africa’s basic education Minister Motshekga knows firsthand that young people socialised too exclusively by adults can lack play skills, and that this can seriously sabotage academic attempts. 

In practise, this means that education departments might be wiser to invest this ‘lost’ academic year in effectively facilitating free social play, rather than once again sacrificing play needs in order to try and cram an already ‘trimmed’ curriculum. It would also be ‘fairer’ in that it could be facilitated and optimised for a lot more young people than the numbers who can be accommodated in socially-distanced school arrangements, or even by ‘distance learning.’

Even if schools do successfully open across the board, optimising free social play will make a huge difference to how well our young people are able to recover and achieve after this time of disruption. 

Professor of educational psychology Anthony Pellegrini found that children are more able to learn after sessions of free social play. He stated that recess breaks are “one of the few times during the day when children have the opportunity to interact with peers and develop social skills free from adult intervention” and that these opportunities for free social play “maximize children’s cognitive performance and adjustment to school.” – The Chronicle of Higher Education 2005

To the extent that schools and other learning facilities are not able to accommodate all young people, a few months of extra play could be exactly what makes it possible for our youth to ‘catch up’ with their education when it is finally safe to do so.

On the other hand, even where schools are able to provide a level of play-based education, this will not address the fundamental need for free play. Dr. Stuart Brown notes that “(Play) doesn’t have a particular purpose and that’s what’s great about play. If its purpose is more important than the act of doing it, then it’s probably not play.” 

Above all, let us bear in mind that “The most important skills that children everywhere must learn in order to live happy, productive, moral lives are skills that cannot be taught in school. Such skills cannot be taught at all. They are learned and practiced by children in play. These include the abilities to think creatively, to get along with other people and cooperate effectively, and to control their own impulses and emotions,” says Dr Peter Gray

So How Do We Prevent PDep-20?

One of the scariest differences between the Covid-19 pandemic and PDep-20, is that with Covid-19, people sick enough to need to be in ICU are easy to spot. Not so the young people worst affected by PDep-20.

Terri Erbacher, school psychologist and co-author of the text “Suicide in Schools: A Practitioner’s Guide to Multi-level Prevention, Assessment, Intervention, and Postvention,” advises parents to be on the lookout for suicidal depression at this time, and warns that it can be “hard to distinguish between a child who is really struggling and one who is having a normal reaction to this COVID-19 pandemic.”  

This makes it critically important to ensure that all young people have adequate play opportunities, whether it ‘seems’ they are suffering, or not. One of the heartbreaking aspects of parental accounts of young suicides is that – nobody saw it coming.

Quite aside from the suicides, the other thing that we won’t see coming – unless we take a long, careful informed look – is the long term effects on the young people in our own families, and the long term effects on our whole society.

We are already struggling with incremental increases in problematic societal trends due to the previous levels of play deprivation that have been slowly growing over the past century. What will our world look like with such a significant increase in all of that, globally, for the foreseeable future?

How long is too long? How little is too little? I don’t know the answer. 

How much is enough? We don’t know. We will probably only find out by making a start, and then listening carefully to the feedback we get from young people.

Here’s my educated guess on what we need for a start:

We need to ensure that every young person has, at absolute barest minimum, access to:

  • 1) An outdoor area, preferably with some sunshine, or otherwise an open indoor space – preferably large enough to run around in, 
  • 2) for at least three hours a day, preferably more, 
  • 3) at least three days a week, preferably more.
  • 4) At least one other (but preferably several) preferred young companions, to share that space and time, without any social distancing and PPE restrictions beyond hand sanitising, plus a normal level of hygiene that could reasonably be ordinarily observed such as prevention of mutual mouthing of objects etc. 
  • 5) Unstructured time to interact with those companions, with adults thoroughly out of the way in the background, available for help and safety but not leading or structuring things or watching/commenting in distracting ways.
  • 6) The real ability to consent to and help shape the details of who, when and where will work for them.

The arrangements above would need to be made by families at their discretion, in accordance with their own assessment of their level of Covid-19 risk. Government simply needs to officially allow them to do this.

For example, governments might rule something such as:

  • On Mondays, Wednesdays, and Fridays
  • between the hours of 9am and 2pm, 
  • groups of less than 10 people may meet without social distancing and with only the PPE that they are personally able to comfortably cope with; 
  • given that no more than 2 people in the group are over the age of 18 years and 
  • given that no less than 2 people in the group are under the age of 18 years; 
  • given that they congregate only out-doors; 
  • given that there is a minimum 6m space between each of such groups. 
  • In order to help further meet Lockdown aims, groups should aim to keep consistent membership to avoid mixing over time; 
  • where possible all members should try to wash or sanitise hands at the start and end of each gathering. 
  • During these gatherings young people must be allowed to engage in significant periods of spontaneous free play and social and physical activities not structured by adults, so that they may exercise their bodies and creative and social abilities in natural ways.

In addition, the government should provide:

  • Suitable guidelines for additional free play time with larger numbers of age-mixed young people at least once a week, preferably more, with full social distancing precautions as needed by level of risk. For example, the Play Today guidelines provided by ACTPSA
  • Suitable guidelines for schools to ensure that enough time and space is allocated for free social play, guided by health experts who should be asked to figure out the minimum measures truly necessary for safety. 
  • TV and Social Media programs to:
    • Educate communities on the importance of free social play and how best to support it.
    • Inspire young people with play ideas to help ‘break the ice’ of play situations made strange by social distancing and PPE.
    • Boost morale and solidarity by inviting young people to participate by sending their play ideas and feedback for broadcast to other young people.

Let’s bear in mind that the point of Covid-19 measures is not to prevent everyone from catching it. Scientists tell us that the majority of people will be exposed within the next two years, no matter what. The aim is to protect the most vulnerable, and to prevent spikes in infection rates that overwhelm available health care – spikes that occur when large numbers of people interact in big groups. 

If each young person’s restriction-free companions are modest in number, fairly consistent, and matched for family Covid-10 status (if someone in your family is positive, you only play social- distance-free/PPE-free with others whose families include a positive case), then the Covid-19 risk is very likely not significant enough to outweigh the risks for PDep-20.

I look forward to seeing what emerges once experts in the field of play deprivation interact with health-care specialists for Covid-19. That interaction should be prioritised, ASAP.

We need to provide opportunities for free social play urgently. For the sake of our children. For the sake of our future.

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